Addressing Shortages in Pediatric Emergency Care—The Evolution of Health Care Access

Schmitz, Gillian

doi:10.1001/jamanetworkopen.2021.10115

Cited by 3 publications

(3 citation statements)

References 10 publications

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“…In the United States, fewer than 5% of ED physicians are board-certified in pediatric emergency medicine, and most of them work in urban centers. 6 Out of concern for this inequity of pediatric care and safety from one ED to the next came the National Pediatric Readiness Project, an initiative to empower all EDs to provide effective emergency care to children. The project is led by the federally funded Emergency Medical Services for Children Program in partnership with the American Academy of Pediatrics, the American College of Emergency Physicians, and the Emergency Nurses Association.…”

Section: Pediatrics: the Challenges And Safety Issuesmentioning

confidence: 99%

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The Most Vulnerable Population

James,

Gabhart,

Galletto

et al. 2024

Clin Nurse Spec

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Section: Pediatrics: the Challenges And Safety Issuesmentioning

confidence: 99%

“…Furthermore, many hospitals do not have inpatient pediatric units, thereby lacking the advantage of expert knowledge sharing. In the United States, fewer than 5% of ED physicians are board-certified in pediatric emergency medicine, and most of them work in urban centers 6 …”

Section: Pediatrics: the Challenges And Safety Issuesmentioning

confidence: 99%

The Most Vulnerable Population

James,

Gabhart,

Galletto

et al. 2024

Clin Nurse Spec

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“…36 The COVID-19 pandemic has placed strains on the health care workforce and there is evidence that clinicians are reducing their hours and retiring early in response to burnout. 37 The literature describes many possible solutions for this potential shortage of trained pediatric staff, such as clinician cross training within an institution among adult and pediatric practitioners, 38,39 knowledge sharing among specialized practitioners like child psychologists, [40][41][42] telemedicine consultation for rural and remote areas, 43 primary care providers taking on specialist roles, 44 and encouraging institutions to support clinicians who choose to work in pediatric specialties with added incentives. 45 Additional supports for the mental health of practising clinicians may also be helpful in addressing chronic clinician burnout.…”

Section: Health Human Resource Managementmentioning

confidence: 99%

Shortages of Care and Medical Devices Affecting the Pediatric Patient Population

Jones,

Walter

2023

cjht

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What Is the Issue? Shortage events, the phenomena when demand exceeds supply, can affect both medical care and medical devices. The COVID-19 pandemic caused a global shortage event, the consequences of which are still being experienced beyond the peak of the pandemic (e.g., the lack of pediatric pain medication available in fall 2022). Children are vulnerable to shortage events as they represent a small proportion of the overall population, have distinct needs, and the pediatric medical device market has historically offered a lack of options. What Are the Technologies? Technologies such as artificial intelligence (AI)-enabled devices, point of care testing, and virtual care options could contribute to alleviating shortages in pediatric care. Technologies such as 3D printing, alternative interventions such as tracheostomy during shortages of mechanical ventilators, and the reprocessing of single use devices such as ventilator tubes have been suggested in times of pediatric medical device shortages. Solutions to shortage events can take the form of novel devices, interventions, or policies; however, due to the complexity of this problem, a multipronged approach is likely needed. What Is the Potential Impact? Shortages can cause delayed intervention, which has health and financial costs. When cancer diagnoses and treatments are delayed, overall survival rates decrease. High-quality early intervention can change a child’s developmental trajectory and improve outcomes for children, families, and communities. Finding solutions to shortages, particularly for children as they are already at risk for health inequities, is crucial to ensure good health care outcomes in the long-term. What Else Should We Know? During a shortage event, alternative interventions may have different safety profiles or require different training than default practices. Equity should be a consideration when implementing technologies, interventions, and policies to address shortage events so that these solutions do not end up replicating or exacerbating existing inequities.

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The pattern of emergency department utilization in pediatric patients who underwent interfacility transfers from the emergency department: a nationwide population-based study in South Korea, 2016-2018

Kim,

Ahn

et al. 2024

Pediatr Emerg Med J

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Purpose: The shortage of pediatric emergency care has become a significant societal issue. This study investigated the usage pattern of emergency departments (EDs) by pediatric patients who underwent interfacility transfers (IFTs) in South Korea, focusing on cases involving single and double IFTs.Methods: This nationwide cross-sectional study included all pediatric patients (< 19 years) who underwent IFTs at regional and local emergency medical centers from 2016 through 2018, using data from the National Emergency Department Information System. After excluding unidentified cases, clinical features and ED use patterns were compared between patients with single IFT, i.e., an IFT after the initial ED visit, and those with double IFT, i.e., a sequential transfer from one medical facility to another.Results: Among 20,888 pediatric cases of IFTs in the ED, 21.0% of disease cases (3,070/14,624) and 11.4% of injury cases (691/6,038) experienced double IFTs. The double-transfer group showed a lower proportion of high acuity than the single-transfer group (22.6% vs. 15.0%; P < 0.001). However, median values of ED length of stay were longer in the double-transfer group, regardless of type of cases (disease: 163 minutes [single] vs. 218 minutes [double]; injury, 111 minutes vs. 172 minutes; all Ps < 0.001). Guardian’s request was a substantial reason for double IFT (disease, 29.9% [919/3,070]; injury, 56.4% [390/691]).Conclusion: Double IFT is common in pediatric patients and strains medical resources, regardless of severity. The high occurrence of double IFT driven by guardians’ requests rather than medical emergencies underscores the need for improved awareness of the emergency medical system among pediatric patients’ caregivers.

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Addressing Shortages in Pediatric Emergency Care—The Evolution of Health Care Access

Cited by 3 publications

References 10 publications

The Most Vulnerable Population

The Most Vulnerable Population

Shortages of Care and Medical Devices Affecting the Pediatric Patient Population

The pattern of emergency department utilization in pediatric patients who underwent interfacility transfers from the emergency department: a nationwide population-based study in South Korea, 2016-2018

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